With the recent developments at San Diego Hospice (SDH) — starting with a Medicare audit questioning how the organization qualifies patients for reimbursement and ending with SDH applying for Chapter 11 bankruptcy on

Feb. 4 — San Diego has been left to wonder what will become of the hospice care that was once so readily available.

Swooping in to answer that question is one of the region’s largest health-care providers, Scripps Health. With SDH’s ongoing investigation and resultant downsizing, Scripps — the largest referral source for SDH — has stepped in to relieve some of the deluge of patients.

“We’ve never opened our own hospice because the community needs were being met by San Diego Hospice, Elizabeth Hospice and other hospices in the community,” said Chris Van Gorder, Scripps president and CEO. “We were approached a couple months ago [by SDH] when they realized they were going to have these challenges, because we were all concerned. They were concerned, and I was concerned, about the patients being cared for in hospice and we wanted to make sure together that their care would not be disrupted in any way.”

At the suggestion of SDH, Scripps decided to go into the hospice business. And because becoming a new hospice care provider in California entails a long and arduous licensing process, Scripps decided to purchase a smaller organization, Poway-based Horizon Hospice, allowing patient care to begin — and continue, for Horizon’s existing patients — almost immediately, as opposed to the delay that could have taken up to a year.

“We were concerned that San Diego Hospice’s challenges might not permit a long ramp up and licensing process, so that’s why we purchased a hospice instead,” Van Gorder said. “Now we have the licensure in place already.”

As to the question of how SDH, the state’s largest hospice, found itself in this situation in the first place — and how other providers can assure they don’t suffer a similar fate — Van Gorder admitted that “there are individuals concerned about the rigid rules Medicare has set up around patients that qualify for hospice care.”

“But the way I look at it is that rules are rules,” he said. “There are a lot of hospice organizations around the country that are following the rules, and it requires a lot of administrative and clinical oversight. And who knows — maybe the rules will change over time. But our responsibility — and we’re a heavily regulated industry, and that’s the reason we have a significant compliance department — is to make sure we do everything we can to follow the guidelines set up by the government.”